BCR–ABL1 tyrosine kinase inhibitors, in combination with chemotherapy and/or steroids, are the standard-of-care therapy for patients with newly diagnosed Philadelphia chromosome-positive (Ph⁺) acute lymphoblastic leukaemia (ALL). Nonetheless, whether these agents are equally effective has remained unclear. Now data from the phase III PhALLCON trial demonstrate that the third-generation inhibitor ponatinib is more effective than imatinib in this setting.

MRD^– CRs were observed in 34.4% of patients in the ponatinib group versus 16.7% in the imatinib group (risk difference 0.18, 95% CI 0.06–0.29; P = 0.002). The median duration of these responses was not reached versus 18 months. Median event-free survival was not estimable in the ponatinib group versus 29 months in the imatinib group (HR 0.65, 95% CI 0.39–1.10).

BCR-ABL1 酪氨酸激酶抑制剂与化疗和/或类固醇联合使用，是新诊断的费城染色体阳性 (Ph ⁺ ) 急性淋巴细胞白血病 (ALL) 患者的标准治疗方法。尽管如此，这些药物是否同样有效仍不清楚。现在，III 期 PhALLCON 试验的数据表明，在这种情况下，第三代抑制剂 ponatinib 比伊马替尼更有效。

普纳替尼组中 34.4% 的患者观察到 MRD ^– CR，而伊马替尼组中这一比例为 16.7%（风险差异 0.18，95% CI 0.06–0.29； P = 0.002）。这些反应的中位持续时间尚未达到 18 个月。普纳替尼组的中位无事件生存期不可估计，而伊马替尼组为 29 个月（HR 0.65，95% CI 0.39-1.10）。